Notes on Idelalisib
Idelalisib, as a PI3K δ inhibitor, should be monitored for liver toxicity, infection risk, and medication management in special populations. It is important to focus on monitoring liver function, lung symptoms, and blood indicators, while strictly preventing serious adverse reactions such as intestinal perforation.
1. Hepatotoxicity risk
(1) ALT/AST should be monitored throughout the entire treatment process, with more frequent monitoring in the early stages. If transaminase levels significantly increase, medication should be temporarily suspended or permanently discontinued.
(2) Avoid using other hepatotoxic drugs in combination. If jaundice or liver damage symptoms occur, seek medical attention immediately.
2. Infection prevention and control
(1) Before treatment, existing infections need to be controlled, PJP prevention should be carried out throughout the process, and CMV viremia should be monitored regularly.
(2) If symptoms of pneumonia appear, treatment should be interrupted. After diagnosis, medication should be permanently discontinued and corticosteroids should be used.
3. Severe diarrhea/colitis
(1) Avoid using drugs that can cause diarrhea in combination. Treatment should be interrupted for severe diarrhea, and the response to anti diarrheal drugs may be poor.
(2) Corticosteroids should be used for patients with colitis, and those who do not experience relief should discontinue the medication.
4. Prevention of intestinal perforation
(1) New abdominal pain and fever should be monitored, and if diagnosed with intestinal perforation, medication must be permanently discontinued.
(2) Diarrhea may be a precursor to perforation, and symptom monitoring needs to be strengthened.
5. Skin reaction management
(1) Individuals with a history of TEN should be prohibited from taking SJS/DRESS and the medication should be discontinued.
(2) Regularly check the skin during treatment, and emergency treatment is required for severe allergic reactions.
6. Blood system monitoring
(1) Neutropenia is common and requires regular blood tests. In severe cases, the dosage may be reduced.
(2) Anemia or thrombocytopenia require dosage adjustment.
7. Medication for special populations
(1) Pregnant women are prohibited from using contraception, and contraception should be administered for one month after the last dose during the reproductive age period.
(2) Medication is prohibited during lactation, and elderly individuals should be evaluated with caution.
8. Omission and Overtreatment
(1) If missed for more than 6 hours, you can make up for it, and if it is less than 6 hours, you can skip it.
(2) Overdose requires immediate medical attention, there is no specific antidote.
Disclaimer：《Notes on Idelalisib》Edited and sorted by Seagull Pharmacy's editors. Please contact us in time if there is any infringement. In addition, the suggestions for drug usage, dosage and disease mentioned in the article are only for medical staff's reference, and can not be used as any basis for medication！